Immigrant Generational Differences in Social Support and Sexual Risk Behaviors Among Men Who Have Sex With Men in Seattle, Washington

Different immigrant generations may encounter distinct sexual opportunities with implications for HIV transmission. Yet, few studies have examined how immigrant generational status is associated with sexual risk behaviors among men who have sex with men (MSM). We explored relationships between immigrant generational status, social support, and sexual risk behaviors among English-speaking MSM using data from surveys conducted in Seattle, Washington, in 2014 (n = 323). We compared the sexual risk behaviors and social support of first-generation, second-generation, and third- and higher-generation MSM, and examined whether immigrant generational status and social support were associated with sexual risk behaviors using logistic regression models. Second-generation MSM reported lower friend social support than first- or third- and higher-generation MSM (p < .05). However, immigrant generational status was not associated with sexual risk behavior outcomes, even after accounting for social support. Results suggest that differences in immigration processes such as acculturation may be more predictive of risk behaviors than generational status alone.

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Sex-on-Premise Venues, Associated Risk Behaviors, and Attitudes toward Venue-Based HIV Testing among Men Who Have Sex with Men in Lima, Perú

10.21203/rs.2.18416/v1 ◽

2019 ◽

Author(s):

Alexander Lankowski ◽

Hugo Sánchez ◽

José Hidalgo ◽

Robinson Cabello ◽

Ann Duerr

Keyword(s):

Hiv Testing ◽

Sexual Risk ◽

Risk Behaviors ◽

Online Survey ◽

Hiv Transmission ◽

Sexual Risk Behaviors ◽

Hiv Infections ◽

Access To Treatment ◽

Cross Sectional ◽

Sex With Men

Abstract Background: In Perú, HIV disproportionately affects men who have sex with men (MSM). Despite widespread access to treatment, the rate of new HIV infections has not slowed over the last decade. Low knowledge of HIV status is a key factor underlying the high HIV incidence observed in this setting – creating conditions for efficient onward transmission in the population. Improving access to HIV testing and prevention services for those at highest risk is an important public health priority. Sex-on-premise venues (SOPVs) – saunas, sex clubs, pornographic movie theaters, hourly hotels, and bars/discos with areas where sex is permitted – may be opportune sites for outreach; however, further research on SOPVs and the populations who frequent them is needed to inform such efforts. Methods: We conducted a cross-sectional online survey of adult MSM in Lima, Perú to evaluate patterns of SOPV attendance, associated sexual risk behaviors, and attitudes toward SOPV-based interventions. Participants were recruited through outreach to social media networks affiliated with local LGBTQ-aligned community groups. Our primary analytic objective was to estimate the association of HIV-related sexual risk behaviors and SOPV attendance. Additionally, we performed exploratory analyses to describe risk behavior stratified by SOPV category and to examine the relationship between SOPV attendance and the use of online platforms to meet sex partners.Results: Overall, 389 MSM completed the survey from November 2018 through May 2019, of whom 68% reported attending an SOPV in the last three months. SOPV attendance was associated with multiple sexual risk behaviors, including transactional sex, group sex, sex while intoxicated, and higher number of total partners. Over two thirds of SOPV attendees indicated they would accept HIV testing if offered at SOPVs. Conclusions: SOPV attendance was common among MSM in Lima who participated in our survey, and SOPV attendees reported significantly greater engagement in sexual risk behaviors related to HIV transmission. Attitudes toward hypothetical SOPV-based interventions were generally favorable. These findings suggest that outreach at SOPVs may be an effective mechanism for reaching a particularly high-risk sub-population of MSM in Perú to deliver targeted HIV testing and prevention interventions.

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